Page:Collected Papers on Analytical Psychology (1916).djvu/337

 congenital psychic anomalies. By this is understood a certain inborn defect of the psyche. Of these 9 per cent., about a quarter were imbeciles. Here we meet certain changes in the brain such as microcephalus, hydrocephalus, malformations or absence of portions of the brain. The remaining three-quarters of these congenital defects present no typical changes in the brain.

Three per cent, of our patients suffer from epileptic mental troubles. In the course of epilepsy there arises gradually a typical degeneration of the brain. The degeneration is, however, only discoverable in severe cases and when the disease has existed for some time. If the attacks have only existed for a relatively short time, not more than a few years, the brain as a rule shows nothing. Seventeen per cent, of our patients suffer from progressive paralysis and senile dementia. Both diseases present characteristic changes in the brain. In paralysis there is most extensive shrinkage of the brain, so that the cortex is often reduced by one half. The frontal portions of the brain more especially, may be reduced to a third of the normal weight. There is a similar destruction of substance in senile decay.

Fourteen per cent, of the patients annually received are cases of poisoning, at least 13 per cent, of these being due to alcohol. As a rule in slight cases nothing is to be found in the brain; in only a relatively few severe cases is there shrinkage of the cortex, generally of slight degree. The number of these severe cases amounts to less than 1 per cent, of the yearly cases of alcoholism.

Six per cent. of the patients suffer from so-called maniacal depressive insanity which includes the maniacs and the melancholies. The essence of this disease is readily intelligible to the public. Melancholia is a condition of abnormal sadness without disorder of intelligence or memory. Mania is the opposite, the rule being an abnormally excited state with great restlessness; likewise without deep disturbance of intelligence and memory. In this disease there are no demonstrable morphological changes in the brain.

Forty-five per cent, of the patients suffer from the real and